Навчально-науковий медичний інститут (НН МІ)
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Item Fetal infections optimization of pregnancy and delivery introduction(Aluna Publishing, 2021) Herevych, N.V.; Nochvina, O.A.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna MykolaivnaThe aim: Improving perinatal outcomes in pregnant women at high risk of intrauterine infection by developing diagnostic criteria and algorithms for managing pregnancy and childbirth. Materials and methods: The study of pregnancy and childbirth was conducted in 72 patients at high risk of IUI, which formed the main group. The control group consisted of 64 patients with a low infectious risk of IUI. Culture, bacterioscopic and biochemical methods were used to identify microorganisms. Peculiarities of infection in the examined women were investigated by determining the concentration of Ig M and IgG in the blood serum and performed polymerase chain reaction for measles virus, cytomegalovirus, parvovirus B19. Serum for the presence of specific immune globulins to these pathogens was examined by ELISA. Comprehensive ultrasound examination in B-mode was performed to determine the feto metry of the fetus and assess its development with the determination of the estimated mass, location, size and structure of the placenta, the amount of amniotic fluid. To determine the condition of the fetus, a Doppler study of blood flow in the uterine arteries, umbilical artery, middle cerebral artery of the fetus and venous duct. Results: Analyzing the course of this pregnancy in women of the studied groups threatened miscarriage and the threat of premature birth occurred in 24 (33.3%) cases, with signs of isthmic-cervical insufficiency were diagnosed in 13 (18.1%) patients. In the control group of patients, the threat of abortion was diagnosed in 15 (23.4%) patients. According to ultrasound examination, patients in the main group in 12 (16.7%) cases were diagnosed with fetal growth retardation, in 25 (34.7%) patients at high risk of IUI there were changes in the placenta, namely, hyper echogenic inclusions in the placenta occurred in 7 (9.7%) cases, dilation of the intervillous space in 8 (11.1%) cases, placental hyperplasia in 7 (9.7%) cases, polyhydramnios was diagnosed in only 5 (6), 9%) cases, with 1 (1.4%) acute polyhydramnios in patients with signs of acute respiratory viral infection during pregnancy. Conclusions: Women at high risk for IUI require close monitoring of the fetus due to the increased frequency of hemodynamic changes in uteroplacental-fetal circulation, including fetal-placental – 22.2% and the occurrence of intrauterine growth retardation. Women with suspected cytomegalovirus infection require determination of seroconversion; in case of immunologically confirmed infection, it is desirable to recognize PCR for cytomegalovirus in the amniotic fluid in order to determine further management and monitoring of this pregnancy.Item Morphological changes of the endometrium in hyperplastic process in women of reproductive age(Aluna Publishing, 2021) Vereshchahina, T.V.; Boychuk, A.V.; Yakymchuk, Y.B.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Datsko, T.V.The aim: To conduct a morphological study of endometrial tissue to identify changes characteristic of viral lesions to develop improved antirelapse treatment of HPE in women of reproductive age. Materials and methods: We surveyed 90 patients of the gynecological department who sought medical for hyperplastic processes of the endometrium in reproductive age. All women underwent hysteroscopy, the resulting material was subjected to morphological examination. Results: It became known that the virus is involved in the pathogenesis of endometrial hyperplasia. It is likely that it exists in epitheliocytes not only as a “passenger”, but also as an etiological factor. It became known that it was in complex hyperplasia with atypia that the percentage reached the highest level, which is a precancerous condition. Conclusions: Typical morphological change of the endometrium – multinucleation, multinuclearity and koilocytotic atypia in women of childbearing age with HPE – was revealed. The presence of infectious pathogens in the endometrium of patients with HPE can be regarded as one of the possible triggers for the development of hyperplastic processes.Item Immunoglobulin indicators to viruses cytomegal and genital herpes in the blood serum of women with non-atipical endometrial hyperprolifetative pathology(Aluna Publishing, 2020) Gorban, N.E.; Vovk, I.B.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Kondratiuk, V.K.; Yemets, N.O.The aim of the study was to analyze the level of Ig M- and Ig G-antibody (Ab) for cytomegalovirus (CMV) and herpes simplex virus type 2 (HSV-2) in serum of women with non-atypical endometrial hyperproliferative pathology. Materials and methods: The analysis of immunoglobulin indices to CMV and HSV-2 in serum of women with non-atypical endometrial hyperproliferative pathology. In women with uterine body polyps the presence of CMV in the uterine cavity was found in 54.8% of cases, in women with non-atypical endometrial hyperplasia in 38.3% of cases. The levels of Ig G-Ab and Ig M-Ab to CMV in serum have a clear dependence on the degree of antigen expression in endometrial tissue. HSV-2 antigens were determined in 22.58 ± 5.31% of women with uterine body polyps and in 8.33 ± 3.57% of patients with non-atypical endometrial hyperplasia while increasing serum specific antibodies to HSV-2. Results: The results indicate that there is a clear link between viral infection of hyperproliferatively altered endometrium and the determination of positive immunoglobulin levels in peripheral blood, which may be a reliable marker of chronic persistent viral infection in a woman’s body. Conclusions: In women with uterine body polyps, the presence of CMV in the uterine cavity was found in 54.84 ± 6.32% of cases, in women with non-atypical endometrial hyperplasia in 38.33 ± 6.28% of cases. The levels of Ig G-Ab and and Ig M-Ab to CMV in serum have a clear dependence on the degree of antigen expression in endometrial tissue. HSV-2 antigens were determined in 22.58 ± 5.31% of women with uterine body polyps and in 8.33 ± 3.57% of patients with non-atypical endometrial hyperplasia while increasing serum specific antibodies to HSV-2. The results indicate that there is a clear link between viral infection of the target tissue (hyperproliferatively altered endometrium) and the determination of a positive level of peripheral blood immunoglobulin, which may be a reliable marker of chronic persistent viral infection in a woman.